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State of Hawaii Health Officials Advise Rationing of Flu Shots to High-Risk Groups 2006

Who should get flu shots?

Federal and state health officials say those most vulnerable to serious consequences from the flu should still get shots despite the shortage prompted by a shutdown of a major vaccine manufacturer.

Those most at risk are:

· Babies and toddlers, ages 6 to 23 months
· People age 65 and older
· Anyone with a chronic condition such as heart or lung disease, asthma, diabetes
· Pregnant women
· Residents of nursing homes and long-term care facilities
· Healthcare workers who care for those in high-risk groups
· Those who care for or live with babies younger than 6 months, and children on aspirin therapy

Officials also recommend that healthy people ages 5 to 49 years be vaccinated with the nasal mist. That can also be given to healthcare workers who aren't caring for those with severe immune system problems and those who care for infants up to 6 months

Source: state Health Department, The Honolulu Advertiser

Details of the vaccine shortage

Q: Will there be enough vaccine for all those in high-risk groups?

A: No. There are about 185 million people in the recommended group, and fewer than a third that many doses of flu vaccine. Health officials had expected that about 100 million doses would be available this year. Now it appears there will be about 1.5 million doses of FluMist nasal spray vaccine, which is licensed only for healthy people ages 5 to 49, and 52 million doses of vaccine made by Aventis Pasteur. Aventis has shipped 30 million doses to doctors.

Q: This year, babies 6 to 23 months old are supposed to get flu shots. Will the vaccine shortage change that recommendation?

A: No. Chiron's vaccine was licensed only for those older than 4, so the shortage will not affect the vaccine supply for babies.

Q: Why can't manufacturers just make some more vaccine to replace Chiron's supply?

A: The vaccine is grown through natural biological methods involving a virus designed specifically to address the strains of flu expected in the coming season, said Dr. Linda Rosen, deputy state health director. Millions of cultures are created to make the vaccine, she noted. "All of that takes quite a bit of time," she said.

Q: What was wrong with the Chiron vaccine?

A: That's not clear. In August, the company told the Food and Drug Administration that it had discovered a problem with the sterility of a few lots of vaccine, or 6 million to 8 million doses. The vaccine was contaminated with the bacteria serratia, which is sometimes found in water and is known to cause urinary tract infections. The company believed it had isolated the problem and taken steps to resolve it, but regulators in England, where Chiron's flu vaccine factory is located, were not satisfied and suspended the company's license.

Q: Has any tainted vaccine been sent to doctors or given to patients?

A: No. Though Chiron reported in July that it had shipped a million doses to distributors in the United States, none of that vaccine has been sent to doctors.

Q: How dangerous is this shortage?

A: Flu causes an average 36,000 deaths a year in the United States and sends about 200,000 people to the hospital. Each year, 10 percent to 30 percent of the U.S. population contracts flu.

Q: How can I protect myself and my family?

A: If you are in a high-risk category, get a flu shot. If you are not in a high-risk group, use precautions to avoid catching or spreading flu, including washing your hands frequently, covering your mouth when sneezing, staying home when you're ill and avoiding contact with ill people.

Q: What flu vaccines are available in the United States?

A: There are two types: a shot made by Aventis Pasteur and a nasal spray called FluMist, made by MedImmune.

Q: Haven't there been flu vaccine shortages before?

A: Yes. In 2000-01, vaccine supplies were delayed because of production problems. At that time, health officials instituted a priority plan for the vaccine similar to the one announced yesterday.
Last year, because flu season got off to an early and severe start, causing serious illnesses in children and adults, there was a rush to get vaccinated, and manufacturers sold out. But the Centers for Disease Control and Prevention says there has never been a year when everyone in recommended groups gets a vaccine.

Q: Will the shortage affect prices?

A: Possibly. In the 2000-01 season, when vaccine supplies were delayed, some doctors reported paying more than four times the expected price, the Government Accountability Office said in a report last week.

— Sources: USA Today, state Health Department, The Honolulu Advertiser